The next generation PHR is a patient portal connected to the HIE

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What attributes must a Personal Health Record (PHR) have to make it attractive to patients and useful to physicians?

Ubiquitous access on the Web is only the starting point, as many have learned. The winning formula must also involve integrating clinically-sourced data to ease the real-world jobs patients and providers are trying to accomplish together.

If consumers had been asking for their data, it could be said that the PHR’s time had already come. The fact is, patients rarely ask physicians for their data. And they haven’t shown much interest in collecting, managing, and sharing it when they are asked to do the work.

Self-reported data is the cornerstone of wellness programs, so employers wind up paying for participation. Physicians rarely have access to data captured through these health appraisals. And they question the clinical value of self-report data that’s been influenced by incentives. Still others are wary of increased liability arising from including self-reported data in the patient record.

Provider-sourced diagnostic and treatment data has the greatest value, but it has been stored in silos. Access to that data through a patient portal is a function of EMR adoption. Meaningful Use will increase the prevalence of EMR’s and patient portals, but their utility will remain hampered until providers share patient data electronically and automatically with non-affiliated physicians.

The good news is that patient portals connected to a Health Information Exchange (HIE) show the greatest promise of realizing the vision of co-mingling data from across the healthcare system. When interfaced with administrative, financial and clinical workflows at the clinics where patients receive care, these integrated patient portals will ease the real-world tasks patients are trying to accomplish.

These jobs include retrieving a complete medical history to make more informed decisions about a proposed treatment option, or simply requesting a referral and scheduling an appointment – with the confidence that their health records will be transferred to the specialist or other care provider (behind the scenes across the HIE).

These capabilities aren’t decades away. They are in plain sight, with adoption of patient portals reaching critical mass within the timeframes outlined by the Office of the National Coordinator (ONC) under Meaningful Use. Unlike its PHR precursors, the integrated patient portal is self-sustaining because it creates economic value for everyone using it:

  • Hospitals and clinics realize value through increased productivity, which optimizes fee-for-service income
  • Increased control over the continuity of care made possible by the integrated patient portal can allow clinicians to benefit from shared savings earned in their accountable care organization, and also receive payments from payers, should the practice certify as a patient-centered medical home
  • Patients save time and money through more efficient access to the clinics that deliver quality care at a competitive price

With exposure to the true cost of healthcare increasing rapidly in the popular media, the desire for an integrated, next-generation patient portal will only become more prevalent. It is what some might call the arrival of consumerism in healthcare – at last.


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